目的 探讨"集束化处理"方案对重型颅脑外伤呼吸机相关性肺炎(VAP)的预防作用.方法 将2008年1～12月使用呼吸机的重型颅脑外伤患者作为观察组(n=205),以2007年1～12月使用呼吸机的重型颅脑外伤患者作为对照组(n=222).对照组患者采用常规治疗及控制感染治疗,观察组患者在对照组治疗方案的基础上采用集束化处理以预防VAP.结果 全年中观察组患者发生VAP人数占使用呼吸机人数的百分比明显低于对照组(t=6.651,P＜0.01).结论 采用集束化处理方案对重型颅脑外伤并使用呼吸机治疗的患者进行干预,可有效防止VAP的发生.%Objective To explore the clinical efficacy of transcatheter arterial chemoembolization(TACE) in the treatment of advanced colorectal carcinoma with hepatic metastases after chemotherapy. Methods 45 patients with advanced colorectal carcinoma and hepatic metastases who had received FOLFOX6 chemotherapy previously and had been assessed as tumor progression were enrolled. Fluorouracil ,oxaliplatin and lipiodol were infused via hepatic artery to perform chemoembolization, and the recent efficacy, adverse reactions and 1-year survival rate were observed. Peripheral blood of patients were collected before and one week after TACK. Flow cytometry was applied to detect the T-lymphocyte subgroups in peripheral blood. Results Alanine aminotransferase (ALT) and CD4+ in peripheral blood of patients one week after TACE were higher than those before TACE(P<0. 05) , while the differences of CD3+ ,CD4+/CD8 + showed no statistical significance(P>0. 05). The common adverse reaction after TACE were mainly abdominal pain,nausea,vomiting,fever and liver function damage. There were 0 case of complete remission,14 cases of partial remission and 21 cases of stability in 45 patients. Conclusion TACE can be served as effective second-line remedial regimen in treatment of patients with colorectal carcinoma and hepatic metastases who failed first-line chemotherapy.
展开▼
